The Financial Cost of Applying Into Diagnostic and Interventional Radiology Residency Before, During, and After COVID-19.

Abstract

Applicants for diagnostic radiology (DR) and interventional radiology (IR) residency programs face significant financial burden due to away rotations, application fees, interviews, and second-look visits. Although COVID-19-era policies such as virtual interviews and preference signaling mitigated against these costs, it remains unclear whether these changes had a lasting impact on expenses for radiology residency applicants. We conducted a retrospective cross-sectional analysis using the Texas Seeking Transparency in Application to Residency database from 2019 to 2025, including US allopathic and osteopathic senior applicants to DR and IR residencies. We categorized data into three time periods: prepandemic (2019-2020), pandemic (2021-2022), and postpandemic (2023-2025). Weighted mean costs were adjusted for inflation, and nonparametric tests were performed. Data from 1,645 DR and 339 IR applicants were analyzed. Average total costs decreased from the prepandemic to pandemic time period for both DR and IR applicants (DR: from $6,024 to $2,288, IR: from $8,462 to $3,546, both P < .001). Postpandemic total costs increased after the pandemic period (DR: $3,783, IR: $5,309, both P < .001). After the pandemic, the largest contributors of total costs were application fees in DR (57%) and away rotations and second-look visits in IR (49%). Although COVID-19-era policies initially reduced costs for radiology applicants, total expenses have rebounded in the postpandemic era, driven by rising application fees and re-establishment of in-person activities.